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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ4718149 (GRO 0034104) ADJ708995 (GRO 0034105)
Regular
Jul 03, 2012

ART QUIROS vs. SUPERIOR TANK COMPANY, INC., SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded an earlier order awarding reimbursement to the Employment Development Department (EDD). The Board found that EDD's claim for reimbursement was invalid because EDD failed to provide the defendant with proper written notice of the lien claim and its extent, as required by Labor Code section 4904(a). Although EDD argued oral notice was given at hearings, the Board held that statutory law mandates written notification for a lien to be valid. Therefore, EDD's claim for reimbursement was disallowed.

Workers' Compensation Appeals BoardSuperior Tank CompanySeabright Insurance CompanyEmployment Development Departmentlien claimCompromise and Releasewritten noticeLabor Code section 4904(a)actual or constructive noticetemporary disability benefits
References
Case No. VNO 0413681, VNO 0469245
Regular
Mar 24, 2008

JANET ANN SAMBAR vs. SANTA CLARITA HEALTH CARE ASSOCIATES dba HENRY MAYO NEWHALL MEMORIAL HOSPITAL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY, TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted Travelers Insurance Company's petition for reconsideration, reversing its prior decision that held Travelers liable for a portion of applicant's cumulative trauma injury. The Board determined that Travelers' prior stipulation was not binding in the contribution arbitration with CIGA, as CIGA was not a party to that stipulation. The Board reinstated the Arbitrator's finding that applicant's date of injury was August 14, 2000, during the coverage period of Superior National Insurance Company, and that no injurious exposure occurred while Travelers was the insurer.

Workers' Compensation Appeals BoardCumulative TraumaLabor Code $\S$ 5500.5Insurance Guarantee Association (CIGA)Superior National Insurance CompanyTravelers Insurance CompanyPetition for ContributionStipulationArbitrationDate of Injury
References
Case No. VNO 0423681, VNO 0469245
Regular
Jun 16, 2008

JANET ANN SAMBAR vs. SANTA CLARITA HEALTH CARE ASSOCIATES dba HENRY MAYO NEWHALL MEMORIAL HOSPITAL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY, BROADSPIRE CLAIM SERVICES, INC., TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied CIGA's petition for reconsideration, upholding its prior decision that Travelers Insurance Company is not liable for the applicant's cumulative trauma injury. The Board found that a prior stipulation by Travelers was not binding on CIGA in a separate arbitration proceeding. Furthermore, the evidence established that the applicant's date of injury was August 14, 2000, and Travelers was not the employer's insurer during the relevant one-year exposure period, thus limiting liability to Superior/CIGA.

CIGATravelers Insurance CompanySuperior National Insurance CompanyHenry Mayo Newhall Memorial Hospitalcumulative trauma injurylast year of injurious exposureLabor Code § 5500.5Petition for Contributionstipulation"other insurance"
References
Case No. ADJ 528016 (LAO 0797447) ADJ 4708211 (LAO 0831457)
Regular
May 08, 2016

JORGE PAREDES vs. COASTCAST CORPORATION, STATE COMPENSATION INSURANCE FUND, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY, CALIFORNIA COMPENSATION INSURANCE COMPANY, LEGION INSURANCE COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., REPUBLIC INDEMNITY COMPANY, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board has granted reconsideration of a prior decision concerning Jorge Paredes and multiple defendant insurers. This grant is a procedural step to allow the Board to thoroughly review the complex factual and legal issues presented in the case. The Board intends to conduct further study and potentially additional proceedings to reach a just and reasoned decision. All future filings related to the petition for reconsideration must be submitted directly to the Board's Commissioners' office, not district offices or via e-filing in EAMS.

WORKERS' COMPENSATION APPEALS BOARDPETITION FOR RECONSIDERATIONGRANT OF RECONSIDERATIONSTATUTORY TIME CONSTRAINTSOFFICE OF THE COMMISSIONERSELECTRONIC ADJUDICATION MANAGEMENT SYSTEMEAMSWCJDECISION AFTER RECONSIDERATIONLIQUIDATION
References
Case No. FRE 186612
Regular
Mar 26, 2008

, Jose Maravilla, vs. , JOSE AND FLORENCIA ALVERNAZ and CIGA, by CAMBRIDGE INTERGRATE SERVICES for FREMONT INSURANCE COMPANY, in liquidation; LIBERTY MUTUAL INSURANCE COMPANY; CALIFORNIA INDEMNITY INSURANCE COMPANY, adjusted by GAB ROBINS

This case involves Liberty Mutual/Golden Eagle Insurance Company's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision finding applicant sustained a cumulative trauma injury to both knees. The WCAB denied reconsideration, finding the Statute of Limitations defense was waived and that the *Benson* case regarding allocation of disability cause was not applicable as there was only one industrial injury. The WCAB adopted the WCJ's report in its entirety for its denial.

Workers' Compensation Appeals BoardJose MaravillaJose and Florencia AlvernaCIGAFremont Insurance CompanyLiberty Mutual Insurance CompanyCalifornia Indemnity Insurance CompanyGAB RobinsFRE 186612Opinion and Order Denying Petition for Reconsideration
References
Case No. OXN 0142199 OXN 0146507
Regular
Aug 04, 2008

JANET I. YANDLE vs. COMMUNITY MEMORIAL HOSPITAL, MAJESTIC INSURANCE COMPANY, CIGA by its Servicing Facility, BROADSPIRE, for SUPERIOR NATIONAL INSURANCE COMPANY, in liquidation

The Workers' Compensation Appeals Board granted reconsideration, affirming the finding that the applicant sustained a back injury between November 16, 1999, and November 16, 2000, with liability resting with Majestic Insurance Company. The Board amended the findings regarding average weekly earnings and temporary disability indemnity rate, recalculating them based on the applicant's reduced hours worked due to her condition. The applicant's permanent and stationary date and the dismissal of a separate cumulative trauma claim were affirmed.

Workers Compensation Appeals BoardReconsiderationFindings and AwardIndustrial InjuryLegal Liability PeriodMajestic Insurance CompanyCIGASuperior National Insurance CompanyLiquidationCumulative Trauma Injury
References
Case No. ADJ9090850
Regular
Jun 28, 2017

VINCE FERRAGAMO vs. ST. LOUIS RAMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INDEMNITY COMPANY, in liquidation, HOME INSURANCE COMPANY, in liquidation, BUFFALO BILLS, INC., GREEN BAY PACKERS, NORTHWESTERN NATIONAL INSURANCE COMPANY merged with HIGHLANDS INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) reversed a prior decision, finding that Vince Ferragamo's current claim for cumulative brain injury is not barred by a 1988 compromise and release agreement. The Board determined that the brain injury was unknown and not intended to be covered by the prior settlement, which focused on orthopedic and other known injuries. Therefore, the doctrine of res judicata did not preclude this new claim, and the case was returned for further proceedings.

Workers' Compensation Appeals BoardVince FerragamoSt. Louis RamsFremont Indemnity CompanyHome Insurance CompanyBuffalo BillsGreen Bay PackersNorthwestern National Insurance CompanyHighlands Insurance Companycumulative trauma
References
Case No. ADJ18217235; ADJ18217236
Regular
Apr 29, 2025

Crispin Bermudez vs. Elkhorn Packing Company, LLC; Zenith Insurance Company

The Workers' Compensation Appeals Board addressed a petition for reconsideration filed by Zenith Insurance Company challenging an arbitrator's finding that applicant Crispin Bermudez was covered by a workers' compensation policy despite signing a waiver. The Board granted the petition, rescinded the arbitrator's decision, and issued a new decision. It found that as a managing member of a limited liability company, Bermudez had executed a valid written waiver of his workers' compensation rights under Labor Code sections 3351(f) and 3352(a)(17). Consequently, the applicant was deemed excluded from the definition of an employee and thus not entitled to workers' compensation coverage.

Workers' CompensationManaging MemberWaiver of CoverageLabor Code Section 3352(a)(17)Conclusive PresumptionIndustrial InjuryPetition for ReconsiderationArbitrator's DecisionRescinded DecisionLimited Liability Company
References
Case No. ADJ7110663
Regular
May 09, 2016

WILLIAM BO MATTHEWS vs. SAN DIEGO CHARGERS, ZENITH INSURANCE COMPANY, NEW YORK GIANTS, INSURANCE COMPANY OF NORTH AMERICA/ACE USA, DENVER GOLD, THE NORTH RIVER INSURANCE COMPANY

This case involves a petition for reconsideration of an arbitrator's decision regarding workers' compensation liability for a professional football player's cumulative trauma injuries. The Workers' Compensation Appeals Board (WCAB) granted reconsideration and modified the arbitrator's award, finding the applicant sustained two separate cumulative trauma injuries due to distinct periods of employment exposure. Consequently, the WCAB ruled that the petitioner, Insurance Company of North America/ACE USA (ESIS), is not liable for contribution to another insurer, The North River Insurance Company (NRIC), which had mistakenly paid a portion of a settlement. The Board affirmed the finding of two injuries, citing a significant break in employment as creating separate compensable periods, but rescinded the award to NRIC, holding NRIC should recover nothing from ESIS.

WCABPetition for ReconsiderationArbitration DecisionContributionCumulative InjuryProfessional Football PlayerInsurance Company of North America/ACE USAZenith Insurance CompanyThe North River Insurance CompanyLabor Code Section 5500.5
References
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